Raffaelli B, et al. - This study entailed the characterization of acute headache in pregnant women in terms of demographic, clinical, and diagnostic features. Experts also attempted to identify the predictors of secondary headache. It was illustrated that secondary headache disorders were a common occurrence during pregnancy. They were noted in over one-third of acute headache cases receiving a neurological consultation. A clear distinction between primary and secondary headaches could not be achieved via most anamnestic and clinical features. Clinicians were recommended to focus on the presence of secondary headache history, elevated blood pressure, fever and abnormal findings in the neurological examination. For the diagnostic process, further inquiry encompassing laboratory tests and neuroimaging were essential.

Methods

• An inspection was conducted of 151 pregnant women receiving neurological consultation due to acute headache.
• It was carried out at the Charite Berlin between 2010 and 2016.
• Researchers compared multiple anamnestic and clinical features of the primary and secondary headache group with the intention of analyzing the risk factors for secondary headache in these patients.

Results

• Findings revealed the diagnosis of primary headache, most common migraine and tension type headache, in 57.6% of the patients.
• The most common aetiologies of secondary headaches were infections (29.7%) and hypertensive disorders (22.0%).
• Both the primary and secondary headache group exhibited similarity in a majority of the anamnestic and clinical features.
• Multivariate logistic regression analysis illustrated that secondary headache history [OR 6.6; 95% CI 1.3-33.1], elevated blood pressure [OR 7.2; 95% CI 2.3-22.6], fever [OR 12.1; 95% CI 1.3-111.0] and abnormal neurological examination [OR 9.9; 95% CI 2.7-36.3] served as independent predictors for secondary headache.
• A connection was brought to the forefront between abnormal thrombocytes, GOT, GPT and CRP, proteinuria, pathologic results of lumbar puncture and neuroimaging with secondary headache, in terms of additional diagnostic procedures.